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The Republican drive to repeal Obamacare is not yet dead, but its state of distress is sufficient to set off recriminations on the right on its presumed failure. The most popular explanation emerging on the right is that Republicans erred by promising Americans too much coverage. The problem for Republicans, argues Peter Suderman, is that they have not yet backed away from universal coverage rhetorically. Philip Klein laments a fatal concession made to liberals: the decision to take Obamacares approach to pre-existing conditions. They argue that the party should instead have designed a stingier program, with catastrophic coverage, rather than make commitments they couldnt carry out. Whats missing from the arguments is any serious analysis of why Republican rhetoric fudged the universal coverage question.

Since Obamacare passed Congress in 2010, Republicans have had two presidential elections to sell America on their alternative vision. When Mitt Romney lost the 2012 election, thus closing out the Republican Partys only opportunity to repeal Obamacare before its coverage expansion took effect, conservatives theorized that Romneys history prevented him from making the necessary full-throated denunciation of the hated law. (To wit, Erick Erickson: He did not articulate strong fiscal conservatism and he never repudiated Romneycare, thereby failing to make any credible attacks on Obamacare.)

Four years later, Trump ran as an opponent of Obamacare, but he hardly embraced an authentic conservative stance. Instead he made extravagant promises of more generous coverage, like I am going to take care of everybody Everybodys going to be taken care of much better than theyre taken care of now.

It is not merely bad luck that deprived conservatives of a committed champion of their health-care vision. Republican candidates responded to what they public has demanded. Indeed, Romneys experience creating the precursor to Obamacare, far from hurting him, provided the foundation for his best moment in the entire campaign. It came in the first presidential debate, when he cited his history as a guide to how he would act as president. (I do have a plan that deals with people with preexisting conditions. Thats part of my health-care plan. And what we did in Massachusetts is a model for the nation state by state.)

Conservatives cannot point to any real-world examples of a country or even a state that has successfully implemented the sort of health-care system they desire. (Some of them mistakenly cite Singapore, whose health-care system relies on massive state intervention American conservatives could never accept.) Thats because theres no electorate in any industrialized country that would tolerate it.

Is that because a conservative health-care plan with catastrophic coverage and high deductibles is technically impossible to design? No, its because such a plan is politically impossible to sustain. People dont want insurance coverage that only protects them against rare disasters. They want to be able to go to the doctor and get treated. In the English vernacular, comprehensive coverage is called good insurance and high-deductible insurance is called bad insurance.

Suppose we lived in a world in which Trump had decided to implement a true conservative health-care plan, and he persuaded Republicans in Congress to take the massive hit to their standing by passing one. What would happen next? Well, once it happened, and tens of millions of people were thrown into the individual market where they could only afford bad insurance, Democrats would start promising to give them good insurance instead. Eventually they would win and give it to them.

The Republican Partys fanatical struggle against Obamacare gave conservative intellectuals a great deal of false hope. By pressuring members of Congress to withhold support in Congress, the Supreme Court to make the Medicaid expansion optional, governors to sabotage state exchanges and turn down the Medicaid expansion, and imposing uncertainty on insurers, they generated an atmosphere of maximum chaos and controversy around the law. They managed to create the impression that Obamacare was a dirty piece of business, and that it was responsible for every bad thing in the health-care system. But they never sold the public on the idea that Americans should not have access to basic medical care.

The nine nations that possess nuclear weapons did not participate in the treaty negotiations.

Congressman Mike Conaways family bought stock in UnitedHealth the same day that a bill repealing Obamacares taxes on insurers advanced in committee.

A viral moment from the G20 summit.

An op-ed co-authored by Clinton strategist Mark Penn tells Democrats to emulate a 1996 strategy the actual candidates did not pursue.

The First Lady was sent in to interrupt them during the G20 summit.

One Democrat in Trenton wants to make sure Beachgate stays in the news.

Rioters mixed with peaceful protesters as world leaders gathered in the German city.

At a meeting than ran 90 minutes longer than expected, Trump and Putin discussed Russian interference in U.S. elections, the secretary of State says.

The definition of the Supreme Courts bona fide relationship is the new battleground.

The vice-president ignored some very large instructions on NASA equipment labeled Do Not Touch.

Competitors in 43 sports from 80 countries have gathered in Tel Aviv for the Maccabiah Games.

At a meeting with Enrique Pea Nieto, Trump returns to the topic that drove a wedge between the two leaders.

The German chancellors husband is shady.

In June, there were an impressive 222,000 new jobs created. How much does Trumps agenda have to do with it?

They may be looking for ways to disrupt the U.S. electric grid, but DHS and the FBI said there is no indication of a threat to public safety.

There were no injuries, but the minor derailment caused more even delays at the troubled station.

Doctors said the congressman, who was shot last month, tolerated the procedure well.

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Why Didn't Republicans Promise a Conservative Health-Care Plan? Because They're Not Idiots. - New York Magazine

Women make up less than 10 percent of the Republican senators in Congress, and the GOPs most qualified (and only top-tier) female hopeful just walked off the Senate playing field with nary a protest from Republican leaders.

Missouri Rep. Ann Wagners challenge to Democratic Sen. Claire McCaskill has been one of the worst-kept secrets of the cycle. The third-term congresswoman, a former United States ambassador and onetimeco-chairwoman of the Republican National Committee, had $2.8 million in her campaign account at the end of March. She had been doing everything a future Senate candidate wassupposed to do, right up until Monday when she announced she was running for re-election toher 2nd District seatinstead.

Im not questioning Wagners commitment to her family or the community she mentioned in her announcement, but Im convinced the congresswoman would still be on pace to challenge McCaskill if there was evidence that the Republican establishment was excited about the prospect of her running for the Senate. McCaskills re-election race is rated a Tossup by Inside Elections.

What might be most remarkable about Wagners announcement is that she bowed out of a race that lacks another serious contender. Its clear that some Republicans in Missouri and Washington, D.C.,are enamored with Josh Hawley, the 37-year-old state attorney general who has been in elected office for six months. But there is no guarantee he will enter the Senate race. If he doesnt, leavingRepublicans without Wagner or Hawley, it could be a colossal miscalculation in a prime takeover target.

Of course, diversity for the sake of diversity is not good, but its hard to get a straight answer from Republicans as to why more wasnt done to encourage Wagner, particularly in the absence of another serious, announced challenger. And with a small pool of willing, capable, and qualified women to run for the Senate across the country, it seems like the party should embrace the ones who come along.

With 10 Democratic senators running for re-election in states President Donald Trump wonin 2016, Republicans have plenty of opportunities to add to their ranks, including adding women to their Senate conference. But there is a dearth of women in position to win.

State Sen. Leah Vukmir, 59, could develop into a credible candidate in Wisconsin. But she hasnt made an official announcement and could have a tough slog through a crowded primary against better-funded candidates before she even got a chance to face Democratic Sen. Tammy Baldwin.

Businesswoman Lena Epstein, 35, was co-chairwoman of Trumps campaign in Michigan and is challenging Democratic Sen. Debbie Stabenow. But as a first-time candidate, she is not a proven commodity. Kathy Neset, who runs an oil field consulting services company, was recently mentioned as a potential challenger to Democratic Sen. Heidi Heitkamp of North Dakota. But Neset would start the race as a political neophyte.

At a time when politicians are incredibly unpopular, strategists tend to fall in love with candidates (including Hawley) without voting records that can be exploited by opponents. But over two-thirds of the 99 elected senators previously served in the U.S. House or a state legislature (or both), so a voting record is not an electoral death sentence.

And in a state that remembers the Todd Akin debacle more than any other, a candidate who has had more time in the public eye may not be such a terrible idea.

In 2012, Indiana state Treasurer Richard Mourdock was viewed as a safe bet even after he knocked off Sen. Richard G. Lugar in the GOP primary, right up until the point when he offered his theological views on abortion during a high-profile debate.

One seemingly obvious way to avoid the temptation of some Republican men to offer their views on abortion and choice is to nominate a woman.

While Hawley is being hailed as a Republican savior who can unite all factions of the GOP, his electoral record is limited to a primary victory (in which he received $1.75 million from one contributor and his family and received considerable support from a Virginia-based super PAC) and a general election victory in a state Trump won by nearly 20 points over Hillary Clinton.

There was room for an anti-establishment candidate in a primary against Wagner, who has been in and round party politics for nearly three decades. But a serious candidate in that mold hadnt popped up yet and thats not the natural place for Hawley to run, considering he has support from prominent, longtime politicians such as former Sen. Jack C. Danforth, who served two terms as Missouris attorney general and was elected to the U.S. Senate before Hawley was born.

Of course, Hawley could run and defeat McCaskill in 2018. He could even become president of the United States one day by defeating 2016 Democratic Senate nominee Jason Kander. But it looks like Republicans missed a rare opportunity to help elect someone other than a white guy to the Senate.

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One Reason Why Republicans Don't Have More Women in the Senate - Roll Call

Sometimes, in some weird markets, too much consumer choice can be a bad thing.

Unfortunately for Republicans, health insurance happens to be one of those weird markets.

Republicans believe the problem with the health-care system is that Americans are forced to buy too much insurance, in plans that are too prescribed. Their solution is to give consumers more choices for what kinds of plans (including no plan at all) they can buy.

The Consumer Freedom Option, recently proposed by Sen. Ted Cruz (R-Tex.), is emblematic of this: It wouldallow insurers to sell plans that dont comply with Obamacare regulations (such as protections for preexisting conditions), so long as they also sell at least one plan that does.

Were guaranteeing them exactly what they have now but giving them more options, Sen. Mike Lee (R-Utah)saidSunday. Options that would inevitably unleash free-market forces, that would in turn bring down the price of health care.

(Jenny Starrs/The Washington Post)

And who doesnt like options?

Choice is as American as apple pie, a core perk of living in a capitalist society. We arefree to choosewhatever car or yogurt we want, from an enormous menu of colors, features, flavors and prices, and economists (generally) believe were happier for it.

But the health insurance market has some distinctive properties that mean too many choices can lead the whole market to unravel.This would leave nearly everyone consumers, insurers and health-care providers much worse off.

Why? The answer is somewhat counterintuitive. So counterintuitive, in fact, that the economists who figured it outwon Nobel Prizesfor the insight. Lets take it step by step.

At its core, offering greater choice in health plans means eliminating both standardization and basic quality minimums.

Eliminating standardization for example, Obamacares rules forwhat benefits are covered, coverage tiers and out-of-pocket maximums would make it much harder for consumers to comparison-shop.

Shopping for health insurance isalreadysuper-complicated and timeconsuming, and lots of people makeobjectively bad choices. You have to comb through fine print and in-network doctor lists. You have to sort out which deductibles and premiums match your familys likely needs and risk tolerance. Imagine how much more complicated this would become if insurers could offer many more plan configurations with more hidden exceptions and fewer quality controls.

Maybe one plan covers breast cancer but not throat cancer. Another covers statins, but only if youve never been diagnosed with heart disease, or maybe just one months supply. With so many variables, and so much opportunity for obfuscation, apples-to-apples comparisons become impossible.

Consumers might also end up buying mini-med insurance that turns out to cover virtually nothing. This happened a lot pre-Obamacare.

Theres a larger problem than consumer confusion, though. Its that the entire individual market would fall apart under Cruzs plan because of adverse selection the idea that people with higher health costs will self-select into more generous coverage.

The cost to a supermarket of selling you a yogurt is basically the same as the cost of selling me a yogurt. Thats not true for health insurance, where I might turn out to be a much more expensive customer than you are.

In a world where patients know more about their health status (e.g., a bum knee) or future health spending (e.g., pregnancy, long-delayed surgery) than insurers do, insurers try to attract only the cheapest, healthiest enrollees by offering the cheapest, stingiest plans. Cruz would eliminate quality minimums, remember.

When consumers have a choice of many plans, and insurers can tweak those plans to attract the healthiest patients, you get a death spiral.

In Cruzs health insurance market, sick people would end up in the relatively generous, Obamacare-compliant plans, which couldnt turn away patients and healthy people would get siphoned off into the mini-med plans, which could. Or these healthy people would drop their insurance altogether, since there would no longer be a mandate.

With only sick people in the Obamacare-compliant plans, the plans would become very expensive, causing slightly less sick people to drop out, causing the pool to get even sicker (and costlier), causing even more people to drop out. And so on.

Cruz says the government would kick in money to subsidize coverage in these plans, but weve already seen how limited Republicans appetite is for adequately funding high-risk pools (which Obamacare-compliant plans would essentially become).

In the end, wed have what we had on the individual market pre-ACA: healthy people buying razor-thin coverage, and few good answers for everyone else. All because Republicans gave consumers, and insurers, that beloved freedom to choose.

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The reason Republican health-care plans are doomed to fail - Washington Post

PALCO, Kan. At his first town hall meeting since coming out against the Senate Republicans health-care bill, Sen. Jerry Moran (R-Kan.) wanted to make himself clear.

He didnt want legislation jammed through on a party-line vote, but he would not necessarily vote against it. Hed met people who tell me they are better off because the Affordable Care Act was passed, but he knew plenty of people were hurting, too.

Its worthy of a national debate that includes legislative hearings, Moran said after the 90-minute event that brought 150 people to a town of 277. It needs to be less politics and more policy.

Moran, the only Republican senator holding unscreened town halls on health care this week, revealed just how much his party is struggling to pass a bill and even how to talk about it. The people who crowded in and around Palcos community center aimed to prove that there was no demand for a repeal of the ACA, even in the reddest parts of a deep red state.

That had taken some planning. Moran announced the Palco event with a full weeks notice, and Kansass pro-ACA groups mobilized to fill it. Planned Parenthood transported at least 20people from the Kansas City suburbs, 4 hours to the east; the citys chapters of Indivisible did the same. The American Association for Retired People and Alliance for a Healthy Kansas made more calls, driving loyal voters to Palco. The result was a polite but heated round of questions that Moran occasionally chose not to answer.

When a 59-year old veteran named Jeff Zamrzla asked if it was time for Medicare for all, Moran waited for applause to die down, then moved on to the topic of Medicaid funding. With a smile and a shrug, he told women in bright pink Planned Parenthood shirts that he wouldnt have an answer they liked.

That was a win for Planned Parenthood patients, said Elise Higgins, 29, the regional director of organizing for Planned Parenthood Great Plains. He didnt just talk about defunding.

Moran did the opposite, largely allowing skeptics of the Republican bill to frame the whole conversation. For all 90 minutes, a woman named Yaneth Poarch, 46, stood behind the senator holding a sign with caricatures of Republican leaders, and the warning When you lose your health care, remember who took it away.

Neither security guards nor staff did anything to move her.

The setting made the dissent, and Morans careful positioning, verge on surreal. Palco was in Kansass rural Republican heartland, miles from Morans home town of Plainville. The visitors from eastern Kansas, and the local Democrats from nearby Hays, found themselves next to Morans old roommate, some high school friends, and a physician. All of it took place in Rooks County, which gave the president a 73-point landslide over Hillary Clinton last year; Moran beat a token Democratic opponent by 79 points.

Until this year, the voters who cast those ballots had confidently favored repealing the ACA. Like Trump, Moran ran on full repeal, claiming to be the first Republican member of Congress to do so.

Obamacare was rammed through Congress on a purely partisan basis in the face of significant public opposition, Moran said in 2015 after the new Republican majority in the Senate passed a test vote on repeal. Moran had chaired the partys 2014 Senate campaign effort, making that majority possible.

On Thursday, Moran took another tone. He did not describe the task facing Republicans as repeal; it was repair, replace, whatever language people are using.

Pressed by activists and voters, Moran said that he did not want to cut back Medicaid. I have concern about people with disabilities, the frail and elderly, Moran said. I also know that if we want health care in rural places and across Kansas, Medicare and Medicaid need to compensate for the services they provide.

After the town hall meeting, Moran told reporters the version of the GOPs bill that he opposed put too much of Medicaid at risk.

Medicaid, except for the extension part of Medicaid, is not really a part of fixing the Affordable Care Act, he said. So weve coupled two things, both of which are very difficult. Kansas is a place thats treated Medicaid payments very conservative. If there are people receiving those payments who dont deserve them, deal with that issue.

In Washington, and at the height of the tea partys activism in Kansas, it had been easy to find conservatives who could sell Medicaid cuts. None of that came out in Palco. Instead, Moran was stopped several times by disability rights advocates who worried that the GOPs bill would destroy their lifestyles.

I am very worried about waivered services, said Mike Oxford, a 58-year old activist with the disability group ADAPT.

Well, my concern with Medicaid is in significant part related to people with waivered services and youre right, said Moran.

Oxford, who carried a sign reading I am Medicaid, said he was comforted by the answer. Here in Kansas, that would be the only place they could find money, he said. The senators right weve been skinned down to zero.

But despite the thanks from people who wanted him to kill the Senate bill, Moran never ruled out a yes vote. Despite the Kansas Hospital Associations opposition to the bill, Moran said he had not found any hospitals that benefited from the ACA. Asked after the town hall whether he could vote for a repeal-and-delay plan favored, in some interviews, by President Trump Moran didnt rule it out.

Thered be skepticism by many Americans because of how long its taken, he said. Can we come up with something in another year? Maybe, if that happened, there would be a desire on the part of all members of the United States Senate to find a replacement.

The desire wasnt there quite yet, he said. There are senators with genuine concerns about this legislation. More senators then are having town hall meetings, said Moran, who has two more town halls in western Kansas in coming days.

Read more at PowerPost

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A town hall in Kansas shows Republican struggles with health-care bill - Washington Post

My hope of Dissolving Illinois to save middle-class taxpayers from being stuck in this toxic wasteland of a state hit a snag on Thursday.

It wasn't the hazmat crews crawling over the Capitol Building in Springfield after finding some mysterious white powder tossed around the governor's office.

It was what Democratic Boss Mike Madigan's legislature did with quisling Republican help in overriding Gov. Bruce Rauner's veto of their $5 billion, 32 percent tax increase without any real structural economic reforms.

For leverage, Democrats and pro-tax activists used warnings from Moody's Investors Service, stressing that without a tax hike Illinois bonds would likely revert to junk status.

Moody's later said that even with the tax increase, that state bonds might still be considered junk, because there were no real spending reforms.

And then 71 members of the state House, dominated by Democrats, wafted their toxic fumes all over the taxpayers of Illinois.

"It's been kind of brutal for me," whined State Rep. Steve Andersson, the Geneva Republican and Boss Madigan enabler who voted for the Madigan tax increase and the Madigan override.

"I've received hate mail, death threats, my personal cellphone has been given out," Andersson said, "but you know what I've thought about? The people, suffering ..."

I thought I could see his lower lip quivering a bit.

And David Harris, Republican Madigan enabler from Arlington Heights, speechified that he had precious little joy. He, too, voted for the Madigan tax increase and the override.

"There's no joy here," Harris moaned. "There's no joy. We are looking into an abyss, a financial abyss, and action is required."

Well, what about all those Illinois homeowners being squeezed out of their homes? Do they have joy?

And what about the small business owners who won't take it anymore, and will take the jobs with them across the state line?

And what about taxpayers who don't hold news conferences, who don't have public relations consultants to call network TV reporters to chronicle their pain? Where's their joy?

They just leave.

As Andersson and Harris whimpered about their bruised feelings and their courage, I was reminded of what my grandfather, Papou Pete, told me about politicians:

"When they speak, the donkeys break wind."

Papou was right. So please stop speaking, Andersson. Please, stop, Harris. It's not only obnoxious. It smells.

So now, after all the talk and all the stunts, who won and who lost?

Boss Madigan won. He's the Khan of Madiganistan for a reason. He works harder, he's more ruthless, he's smarter, and he's cautious, until he strikes.

He wins because he knows what he wants: the money and the power. That's all he's ever wanted.

And Rauner lost, big time.

Madigan pushed the tax increase through days ago, with mostly Democratic support, but also with the help of 15 Republican votes. He then overrode Rauner's veto on Thursday.

With all the political noise over the past few days, I don't want you to forget something else. And without that something else, none of this would have happened.

Those 15 Republicans who voted for the tax hike gave Madigan enough votes to pass the tax and to give ample political cover to eight House Democrats, some in suburban districts, to vote against it.

In effect, the 15 Republicans protected the Madigan Democrats, so Madigan didn't have to expose his pet minions. And now they can send out direct mail advertising approved by Boss Madigan to tell voters in their districts that they're Democrats independent of Madigan, that they care for middle-class suburban taxpayers, that they haven't lost touch.

Of course that's nonsense. If Boss Madigan told them to lick the white powder off the Capitol Building floor, they'd do it.

There were 10 Democrats who voted against the tax increase: Mike Halpin; Marty Moylan; Michelle Mussman; Jerry Costello II; Natalie Manley; Sue Scherer; Katie Stuart; Sam Yingling; John Connor; Rita Mayfield.

Eight of these, all but Connor and Mayfield, were expected to have been targeted by Republicans.

You need a scorecard in this game.

Madigan would never have allowed them to risk voter anger. Because without them, he'd risk losing his majority and then he wouldn't be Speaker of the Illinois House.

There will be much talk of Republicans and Democrats jumping from tax vote to veto override, and who flipped and who didn't. But please consider this:

That's all about confusing the voter.

Remember that without the 15 Republicans voting for the tax hike, the rest of it would have been moot. Some Republicans were in districts where universities eat tax dollars, and perhaps the universities will protect them. Yet each deserve a vigorous primary challenge.

And I'm mentioning the 15 Republican Madigan enablers here by name, so you can keep score on them as well:

There was the lead whiner, Andersson; and Terri Bryant; John Cavaletto; C.D. Davidsmeyer; Mike Fortner; Norine Hammond; and Harris, because after he spoke, all the donkeys were exhausted.

And Chad Hays, who is not seeking re-election; Sara Wojcicki Jimenez; Charlie Meier; Bill Mitchell; Reggie Phillips; Bob Pritchard; David Reis; Michael Unes.

Yes, Papou Pete is long gone, but he understood their kind.

They always have good reasons for reaching into your pocket and taking your money. They're always sad about it. And some almost cry.

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Boss Madigan's Republican enablers give his minions cover - Chicago Tribune